The work is devoted to the study of possible predictors of atrial fibrillation (AF) recurrence after interventional procedures. Purpose: to study the echocardiographic predictors of AF recurrence in patients with arterial hypertension after pulmonary veins catheter ablation.

Абстрактный   Цель исследования:  оценить роль спекл-трекинговой эхокардиографии в выявлении ранней дисфункции миокарда у женщин с артериальной гипертензией в перименопаузальном периоде.   Материал и методы. В исследовании приняли участие 50 женщин перименопаузального периода в возрасте от 45 до 55 лет. Перименопауза диагностировалась на основании клинического осмотра, включающего осмотр у гинеколога и исследования гормонального статуса женщины. Выборка женщин была разделена на две группы в зависимости от наличия артериальной гипертензии. В основную группу вошли 24 пациентки с артериальной гипертензией, диагностированной в перименопаузальном периоде. Перечисленные выше методы обследования также включали электрокардиографию, эхокардиографию и спекл-трекинговую эхокардиографию.   Результаты. По данным спекл-трекинговой эхокардиографии выявлены статистически значимые показатели в базально-антеропостероидном и нижнебазальном сегментах (р = 0,016; 0,001). Разница индекса массы миокарда левого желудочка была статистически значимой в сравниваемых группах (р = 0,038). ROC-анализ использовался для оценки качества полученной модели логистической регрессии. Площадь под ROC-кривой составила 0,806 ± 0,065 (95% ДИ: 0,679–0,933, p <0,001). Это указывает на «очень хорошее» прогностическое качество модели.   Заключение: в группе больных с артериальной гипертензией более чувствительны показатели базального переднеперегородочного и базально-нижнего сегментов, что может быть использовано как значимый показатель дисфункции при неизменных показателях стандартной эхокардиографии.

BACKGROUND: This article describes cardiac myxoma in a pregnant woman at 15 weeks of gestation. CASE PRESENTATION: A large left atrial myxoma, despite the asymptomatic clinical presentation, was diagnosed during echocardiography. Given the significant risk of cardiac complications, the tumor was surgically removed at 19 weeks gestation. The postoperative period as well as the second and third trimesters of pregnancy were uneventful. At 40 weeks of gestation, live full-term baby was born by vaginal birth mode of delivery without any apparent pathology. CONCLUSION: This case demonstrates the significance of timely diagnosis and treatment of myxoma as well as the need for continuous monitoring at different stages of pregnancy and their positive impact on disease outcome.

Funding Acknowledgements Type of funding sources: None. Introduction Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. In arrhythmology, catheter ablation methods are successfully used in the treatment of AF. Objective To assess the significance of left atrial (LA) longitudinal deformity in predicting AF recurrence after catheter ablation. Research material and methods: The study was carried out on the basis of NJSC "National Scientific Cardiac Surgery Center" in the Department of Interventional Arrhythmology. The study included 150 patients, whose average age was 62.4 ± 7.47 years. All patients underwent catheter ablation of the pulmonary veins. Patients were divided into 2 groups depending on the effectiveness of ablation: with recurrent AF (47) and patients who maintained sinus rhythm for 12 months (103). Heart parameters were assessed in two-dimensional (2D) conventional and speckle-tracking echocardiography of the left atrium (LA). Results According to the results of Speckle-tracking echocardiography, the peak values of longitudinal and contractile LA deformity were significantly lower in the group where AF relapsed soon and amounted to -17.4319±0.52 and -22.9194±1.13, respectively (p&lt;0, 0001). According to the results of an echocardiographic study, the LA volume was 100.10±28.5 ml in the first group and 74.85±14.44 ml in the 2nd group (p&lt;0.01), which exceeds normal values. Statistical difference revealed (p&lt;0.01), such indicators as the indexed volume of the LA and its area, which amounted to 47.27±9.21 ml/m²; 38.13±6.85 ml/m²; and 26.61±3.37 cm²; 22.72±3.12 cm², respectively. LVML in group 1 was 225.3±44.1, in group 2 160.29±40.61 (p&lt;0.01), LVMI was 112±19.25 and 83.30±20.17 (p&lt;0.01). Correlation analysis revealed a positive relationship between AF recurrence and LA area (r=0.599; p&lt;0.01), longitudinal LA deformity (r=-0.804), RA area (r=0.479; p&lt;0.01), LVMI (r=0.557; p&lt;0.01), LVMI (r=0.367; p&lt;0.01), LV EDR (r=0.381; p&lt;0.01), LV ESR (r=0.375; p&lt;0 .01). Analysis of the ROC curve of the relationship between relapse and LA volume showed that the area under the ROC curve was 0.786 ± 0.045 with 95% CI: 0.679-0.858. Assessing the relationship between AF recurrence and LA area, the area under the ROC curve was 0.783 ± 0.043 with 95% CI: 0.699-0.867. The threshold value of the volume and area of the LA at the cut-off point is 81.5 (sensitivity and specificity were 70.2% and 66%%) and 24.5 (sensitivity and specificity were 68.1% and 68.9%) ( p&lt;0.001). Conclusion Speckle tracking echocardiography is a valuable tool for evaluating left atrial function in patients with AF and may be of diagnostic value for the prognostic detection of AF recurrence in patients after catheter ablation. Evaluation of echocardiographic parameters in patients with AF revealed that an increase in such parameters as the volume and area of the left and right atrium, LVMI, MMLV, LV EDD, LV ESD has a moderate positive correlation with recurrent AF.